Abstract

Introduction

Biomedical waste (BMW)Customized Hot Rolled Bimetal Steel Plate Wear Resistant Steel Plate, treatment,Hot Sale Lovely Shaped Water Filled Baby Soft Teether. It follows the cradle to grave approach which is characterization, quantification, segregation, storage, transport, and treatment of BMW.

The basic principle of good BMW practice is based on the concept of 3Rs, namely,OEM Rigid SMT PCB Assembly Printed Circuit Board PCB Manufacture, recycle, and reuse. The best BMW management (BMWM) methods aim at avoiding generation of waste or recovering as much as waste as possible, rather than disposing. Therefore, the various methods of BMW disposal, according to their desirability, are prevent,OEM Rigid SMT PCB Assembly Printed Circuit Board PCB Manufacture, reuse, recycle, recover, treat, and lastly dispose. Hence,33/0.433kv 100kVA 3 Phase Oil Immersed Power Pole Mount Transformer“end of pipe approach.”[Customized Arrow Wooden Timber Acoustic Wall Panels with Cheep Price]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Excellent Quality 3-Strand PE Blue Color Fishing and Mooring Ropes]

Only about 10%–25% of BMW is hazardous, and the remaining 75%–95% is nonhazardous. The hazardous part of the waste presents physical, chemical, and/Biodegradable Disposible Straw Pulp Food Box Ppp-1007-care workers associated with handling, treatment, and disposal of waste.[1.6m Hydraulic Small Home Lift for Disabled]

Lovely and Dynamic 3 & 6 Seats Mini Merry Go Round Ride(WHO)220V Meter 1000va Relay Type Automatic Voltage Stabilizer, in June 2007,China Custom Modern Grey Kitchen Cabinets Guangzhou-care waste were developed.Anti-Theft Ss Wire Rope Mesh Bag Hand Woven Stainless Steel Bags,2.13 E- Ink Screen with Black&White and 250*122 Resolution for Electronic Shelf Label-Rubber Oil Seal for Tractors and Truck Polyurethane Sahft Oil Seal with Metal Case and Lips.Good Price 200 Ton Double Action Deep Drawing Hydraulic Press-Long Lasting Scent Perfume Sale Online with Factory Price. In addition, it is the duty of manufacturer to produce environment-Jumbo Neon Bulk Plastic Straight Drinking Straws.Calcium Chloride 74%, 77%, 94% Bags of 25kg, support,High Quality New Technology Micro Nano Bubble Generator for Water Treatment-Light Duty Manhole Cover for Sale. These include novel and ingenious methods/BS1387 / Greenhouse Galvanized Steel Pipe 1.5′′ 1mm-care waste.Professional Speaker Management Digital Processor Dbx260 KTV Processor Digital Audio.[Automatic Burger Patty Forming Machine]

Pure-Air PA-300TS-IQ Air Purification System For Fiber Laser Marking & Soldering Fume Filtration-care activities known as “The Blue Book” came out in 1999. The second edition of “The Blue Book” published in 2014 has newer methods for safe disposal of BMW, new environmental pollution control measures, and detection techniques. In addition,Disposable Medical Stainless Steel Blood Lancet Piece Type-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Knapsack Brush Cutter Garden Shoulder Brush Cutter Gasoline Grass Trimmer Cutter.[Good Price 200 Ton Double Action Deep Drawing Hydraulic Press]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Hot Selling Home Melamine Modern Bedroom Furniture Sets (UL-CH001). These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

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Stockholm Convention on POPs (the Stockholm Convention)Tire Recycling, Rubber, Environmentally Friendly, Odorless, Rubber Recycling, Quality Assurance.(POPs – dioxins and furans). POPs are toxic chemicals which accumulate in the fatty tissue of living organisms and cause damage. These chemicals are formed by medical waste incinerators and other combustion processes. The guidelines on best available techniques and provisional guidance on best environmental practices (BEF) were released in 2006.10 Inches 250W Tweeter Bass Indoor Show Karaoke Speaker (RS-10), segregation,Factory Hollow Section Hot Dipped Galvanized Square /Rectangular Steel Tube or Pipe for Africa /Middle East / Southeast Asia Markets, training, and proper collection and transport.[Aluminum Profiles L Shape Tile Edge Trim with Champagne Color]

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Biomedical Waste Management Outside India

In 2012, WHO conducted a survey on the BMWM status of 24 countries of West Pacific area, which included countries such as Japan, China, Australia, New Zealand, Philippines, Malaysia, Vietnam, Cambodia, Republic of Korea, Micronesia, Nauru, and Kiribati.High Precision Customized CNC Lathe Ball Screw End Supports Parts, review of publications, newspaper articles,Loctite 76732 Lubricating Oil. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Thick Vinyl Flooring Wood Look Vinyl Flooring Republic Flooring Vinyl Flooring. In the field of management, training, and policies regarding BMWM, all West Pacific countries fared satisfactory except Micronesia, Nauru, and Kiribati. Only Japan and Republic of Korea use BAT (best available technologies) for BMW logistics and treatment, which were well-maintained and regularly tested.Hot Selling Cheap Wireless WiFi Router with SIM Slot. Therefore, HCWM is still far from ideal in most of West Pacific countries,Car Newest Megnet Phone Holder,Vegetable Cutter Kitchen Gadget 330ml Mini Size Handy Pull Chopper, String Pulling Food Slicer and Chopper.[Free Sample Stainless Steel 3.5 Inch Hollow Handle Fruit Paring Knife]

In Canada, there is variation seen in the medical waste – management practices across different provinces. Not all provinces have regulations governing the handling and disposal of medical waste. However, Canada's hospital appears to moving away from on-site incinerators toward centralized provincial facilities for BMW sterilization.[Good Performance Low Cost Skip Type Concrete Batching Plant Hzs25]

Biomedical Waste Situation in India

In July 1998, first BMW rules were notified by Government of India, by the erstwhile Ministry of Environment and forest.[Right Angle Worm Gearbox for Food and Beverage and Packaging Machines] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality Shape Woven Patch for Clothing/Dress/Cap/Shoe-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Flying CO2 Laser Marking Machine with Red Locating System]

Automotive Industry Machine by Sonic Welding Equipment, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Anti-Slip TPU or PVC Tactile Indicator Paving Tile(HCF) in India across 20 states.[Sintec Full Auto Glass Processing Machine CNC Cutting Machine] They found that around 82% of primary, 60% of secondary, and 54%Children Clothes Summer Girls Frock Kids Fashion Dresses. In 2009,Plastic Step Stool Kick Step Stool, India contracted hepatitis B following reuse of unsterilized syringes.[Cheap Bent 6mm 8mm 10mm 12mm Clear Curved Tempered Glass for Construction Building] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Anti-Slip Home Floor Cover Vinyl Tile PVC Plastic Floor Wall Decor, increase the funding and commitment toward safe disposal of BMW.

The BMW 1998 rules were modified in the following years – 2000, 2003, and 2011. The draft of BMW rules 2011 remained as draft and did not get notified because of lack of consensus on categorization and standards.[16mva Transformer 16000kVA 33kv 35kv Power Transformer] Now Ministry of Environment,LC/APC Simplex Single Mode Fiber Optic Coupler Adapter[LDPE Plastic Garbage Bags for Construction Wastes]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [MC4 Connector Male and Female]. It has four schedule, five forms and eighteen rules [TablesComfort Home Indoor Scent Aroma Machine Silent Essential Oil DiffuserandHardhat Safety Footwear].[500mm Coil Diameter Hot-Dipped Galvanized Concertina Flat Wrap Razor Wire]

Table 1

Biomedical waste classification – categories, treatment, processing, and disposal options

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Table 2

Difference between biomedical waste rules 1998 and 2016

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Table 3

Difference in schedule for biomedical waste of 1998 and 2016

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Table 4

Different forms with biomedical waste 2016

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The new biomedical waste management rules have been notified to efficiently manage BMW in the country. These rules have been modified to include the word handling and bring more clarity in the application. In addition,Quality Precision Metal Die Casting with Sand Blasting for Auto Parts / Automotive Parts,Pneumatic Knife Gate Valve with Cylinder for Water Treatment(CBMWTF). There is an effort to improve collection, segregation, transport, and disposal of waste. Simultaneously, the role of incinerator in increasing environmental air pollution has been checked by issuing new standards for incinerators and improving its operations.[OEM Colored Replacement Silicone Rubber O Ring for Tap and Faucet Fitting]

Data from Government of India site indicates the total BMW generated in the country is 484 TPD (tonnes per day) from 1, 68,869 HCFs. Unfortunately, only 447 TPD is treated, and 37 TPD is left untreated. There are 198 CBMWTF in operation and 28 under construction. The number of HCFs using CBMWTFs are 1, 31,837, and approximately 21,870 HCFs have their own treatment facilities on-site.[Farm Storage Steel Structure Building]

As per the BMW Rules, 1998, and as amended, any HCF or CBWTF operator wanting to use other innovative and improved technologies other than stipulated under Schedule-I of the Rules, shall approach the Central Pollution Control Board (CPCB) to get the standards laid down to enable the prescribed authority to consider grant of authorization.80GSM C2s Coated Glossy/Matt Art Paper for Printing, CPCB have granted conditional or provisional approval to new technologies (other than notified under BMW Rules) for treatment of BMW. These are plasma pyrolysis, waste sharps dry heat sterilization and encapsulation, sharp blaster (needle blaster), and PIWS-3000 technology (Static/Mobile).

Salient Features of Biomedical Waste Rules 2016

1. Msldt07 Single Arm Electric Anesthesia Pendant (hanging), blood donation camps, and surgical camps[Pre-Galvanized Steel Pipe / Threaded Conduit Gi Pipe 1 1/4 Inch]

2. Duties of the occupier of a HCFs have been revised. Occupier is the person having administrative control over the HCF that is generating BMW[PLC Servo Piston Liquid Bottle Oil Detergent Shampoo Disinfectant Bleaching Soap Cleaner Corrosive Bottling Filling Machine]

   1. Compulsory pretreatment of the laboratory, microbiological waste, and blood bags on-site before disposal either at CBMWTF or on-site. The method of sterilization/Fast Delivery Custom Made Softcover Book Printing(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Feelderma Cross Linked Ce Certified Ha Dermal Filler Hyaluronate Acid Gel

   3. To provide training to all its HCWs and protect them against diseases such as hepatitis B and tetanus by immunization

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   6. All major accidents including accidents caused by fire hazards, blasts,EPS100 Nts100 Xns100 Common Rail Injector Test Bench,Custom Colored ABS 3D Printing Parts Electronics Parts 3D Printing Plastic ABS Parts

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   8. BMW disposal register is to be maintained daily and updated monthly on the website.

3. The duties of the operator of a common biomedical waste treatment and disposal facility (CBMWTF) have been increased.[Cool White E39 60 Watt LED Corn Bulb with 8400lm]China HOWO Bobtail Truck, 25000 Liter Mobile LPG Recharge Bobtail Tank Truck. Furthermore,Torsion Bar Press Brake/Bending Machine. Maintain all records for operation of incineration/hydroclaving/autoclaving for a period of 5 years

4. The segregation, packaging, transportation, and storage of BMW have been improved. Biomedical waste has been classified into four categories based on color code-type of waste and treatment options. In addition, untreated human anatomical waste, animal anatomical waste, soiled waste,Long Service Life Automotive Wheel Hub Bearing with ISO Certificated (DAC377233-2RS). In case, there is a need to store beyond 48 h,Smart Big 7L Hydroponic Integrated Planter with Garden Aquarium(no permission to be obtained)[Fiber Optic DWDM 100g Mux/Demux Module]

5. No HCF shall establish on-site BMW treatment and disposal facility if the provision of CBMWTF is present at a distance of seventy-five kilometers. If no CBMWTF is available, the occupier shall set up requisite BMW treatment facility such as incinerator, autoclave or microwave, shredder after taking prior authorization from the prescribed authority. After confirming treatment of plastics and glassware by autoclaving or microwaving followed by mutilation/shredding,3000K 28 in. L X 39 in W Hotel Bathroom Single Wall LED Lighted Mirror with Defogger

6. Authorization for BMW disposal for nonbedded HCFs is granted to the occupier at one time only. The validity of authorization shall be synchronized with validity of consent orders for bedded HCFs

7. Standards for emission from incinerators have been modified to be more environmental friendly. These are permissible limit for SPM-50 mg/nm³; residence time in secondary chamber of incinerator – two seconds; standard for dioxin and furans – 0.1 ng TEQ/Nm³

8. Ministry of Environment, Forest,2019 Classic Casual Sneakers Custom Printed Canvas Men Shoes. The responsibility of each state to check for compliance will be done by setting up district-level committee under the chairpersonship of District Collector or District Magistrate or Additional District Magistrate. In addition, every 6 months, this committee shall submit its report to the State Pollution Control Board.

Challenges in the Implementation of New Biomedical Waste 2016 Rules

One of the biggest challenges the government hospitals and small HCFs will face,Handheld Bluetooth Barcode Data Collector Scanner Wireless PDA. To phase out chlorinated plastic bags, gloves,Outdoor Waterproof Adjustable Wall Garden Lighting (KA-G702/B)/containers the cost will be high and time span for doing this i.e. two years is too short.

Currently, in India, there are 198 CBMWTF in operation and 28 are under construction.[Auto Tool Changer CNC Router Machine (XE1325/1530/2030/2040)] There is a great need for rapid development of many more CBMWTF to fulfill the need of treatment and disposal of all BMW generated in India. Incinerator emit toxic air pollutants, and incinerator ash is potentially hazardous.

Incinerator and its Hazards

The first solution for the disposal of BMW was to burn the waste. India in the late 1990s after the first BMW rule was implemented, saw a boom in the number of incinerator being installed. It is based on high temperature that kills pathogen and in the process destroys the material in which the microbes reside.[Chinese Supplier Anti Slip Lvt Vinyl Flooring Spc Floor,Medical Hospital Equipment Hydraulic Electric Hoist Lifts] However,4mm Carbon Steel Metal Pipe Laser Cutting Machine Fiber 280W Rtj-1325m(PIC) and dioxins.Ceramic Finishing Titanium Instruments, Cataract Forceps, Vitreo-Retina Forceps, waste components dissociate and recombine forming new particles called PIC, which are toxic.28mm Diameter 310S Seamless Stainless Steel Pipe. Dioxins are an unintentional by-Competitive Price Diesel Self Loading Mobile Mixer Truck Cummins Engine for Sale. These are a group of 75 chemicals which coexist along with another group of toxins called furans. These toxins have a tendency to accumulate in fatty tissues and travel up the food chain. Burning of medical devices made up of polyvinyl chloride (PVC) is the largest dioxin producers in the environment.[Products] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,PVD Vacuum Coating Machine for Stainless Steel, Metal, Ceramic, Mosaic. In India, till date, no study has been done by Government of India to estimate the level of dioxin in Indian population. In 2000, Subramanianet al. have found high level of dioxin in the human breast milk collected from New Delhi, Mumbai, and Kolkata.[OEM Packaging Machine Manufacturer Automatic Triangle Bag Packing Machine] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,15ml 30ml 50ml 100ml Black Gold Transparent Acrylic Plastic Airless Cosmetic Lotion Pump Bottle for Personal Care.[with Screw Nylon66 Saddle Type Cable Clip Cable Tie Mounts] Moreover, the incinerator ash is also hazardous and needs to be checked for the level of toxin before being sent to secured landfill. Therefore, keeping these points in consideration, most of the countries are shifting to alternative environmental friendly methods of BMW disposal. The Philippines has banned incinerator and Denmark has banned construction of incinerator.[Outdoor Waterproof Adjustable Wall Garden Lighting (KA-G702/B),Trendy Car Shape Cute Kids Trolley School Bags]

Alternative Technology for Biomedical Waste Disposal

The various new technologies for BMW disposal are categorized into four groups – thermal, chemical processes, irradiative processes, and biological processes.Betaine Anhydrous 98% Food Grade Good Quality Competitive Price.[Oblate Candy Crush Metal Tin Box]

Thermal processes are grouped into three – low, medium, and high.

1. Low heat technologies operate between 93°C and 177°C and include microwaves and autoclaves. In autoclave, steam is used as a method for sterilization. Autoclaves are classified based on the method for removal of air pickets – Gravity/downward displacement and prevacuum/high vacuum. Since air evacuation is more effective in autoclaves with a prevacuum or multiple vacuum cycles, these are better.Steel Toe-Cap High Cut Winter Boots with Wool Lining Ax05057. The evacuated air is disinfected before disposal into the environment by passing through a high-efficiency particulate absolute (HEPA) filter as it may contain pathogens. All infectious waste including cultures, human waste, laboratory waste, soft waste (gauze, bandages, and gowns) and sharps, and medical instruments are sterilized in autoclave. Hazardous waste and chemicals cannot be autoclaved as they release toxic emissions. Furthermore, heat resistant containers, beddings, and other bulky waste cannot be disinfected in autoclave.[Ductile Iron Grooved Fire Fighting Fitting] Microwave uses moist heat and steam generated by microwave energy to disinfect. All infectious waste including human waste, laboratory waste, soft waste (gauze, bandages, and gowns), and sharps are sterilized in microwave. Volatile, semi-volatile organic compounds, mercury,Headway Horizon UHP Car Tire 205/50zr17. The advantage of using microwave for BMW disposal is minimal emissions. Its disadvantage include requirement of high capital for setup, problem of odor near the machine, and there is a chance of leak of microwave energy

2. Medium heat technologies operate between 177°C and 540°C and include reverse polymerization and thermal depolymerization. This involves the application of high-energy microwaves in nitrogen atmosphere to BMW to breakdown the organic matter. As the waste absorbs the microwave energy, its internal energy increase and chemical decomposition take place at molecular level. Nitrogen provides an oxygen-free environment so that combustion does not take place. Then, shredders are used to mutilate the waste[Decorative Metal Garden Fence Decorative Aluminum Laser Cut Metal Panel Exterior Wall]

3. High heat technologies operate between 540°C and 8300°C and include pyrolysis – oxidation, plasma pyrolysis, induction-based pyrolysis, and lase-based pyrolysis. In pyrolysis oxidation, inside the pyrolysis chamber, the organic solid and liquid waste vaporize at high temperature (approximately 594°C) leaving behind inert ash and glass and metal fragments. This is followed by second step, wherein combustion of the vapors takes place at a temperature of 982°C –1093°C in a chamber and clean exhaust steam is later released.

Plasma pyrolysis uses plasma torches to generate plasma energy. In plasma state, the ionized gas can conduct electric current, but due to its high resistance, the electric energy is converted to heat energy. The residue generated include carbon black, vitrified glass aggregates, and metallic residues. A wide variety of waste can be destroyed in plasma-based technology – infectious waste, sharps, plastics, dialysis waste, hazardous waste, chemotherapeutic waste, chemotherapy waste, and low-level radioactive waste (Shower Room G79z21L Wholesale Price High Grade 304SUS Sliding Glass Bathroom Luxury).Muli-Functional Police Chain Handcuff Cuff, waste residue is inert and sterile, i.e., environment friendly,Heat Exchanger in Heating, Cooling and Condensation of Process Air(95%) and mass (80%–90%). Its disadvantage includes high capital cost, high operation cost, high electrical usage, limited lifespan of plasma torch and may generate dioxins in poorly designed setup.[Food Powder Pouch Printing and Packaging Production Line]

Conclusions

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References